Active NPI
Kelly Holcomb, PHARMD
- Pharmacist
- Jacksonville Beach, FL
National Provider Identifier
1467938696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS43901
- Practice address
- 1504 3Rd St S
Jacksonville Beach, FL 32250-6312 - Phone
- (904) 246-7596
- NPI assigned
- Jul 11, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS43901 | FL | Primary |
Addresses
Primary practice location
1504 3Rd St S
Jacksonville Beach, FL 32250-6312
Mailing address
1504 3Rd St S
Jacksonville Beach, FL 32250-6312
Phone (904) 246-7596
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS43901 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS L.L.C. | Past | Accepting new patients | |
| Holiday CVS LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacy
- Wesley Chapel, FL
- NPI 1770467466
-
- Pharmacy
- Jacksonville Beach, FL
- NPI 1366546244
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531267200000",
"number": "1467938696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1504 3RD ST S",
"city": "JACKSONVILLE BEACH",
"state": "FL",
"postal_code": "322506312",
"telephone_number": "904-246-7596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1504 3RD ST S",
"city": "JACKSONVILLE BEACH",
"state": "FL",
"postal_code": "322506312",
"telephone_number": "904-246-7596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLCOMB",
"first_name": "KELLY",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-11",
"last_updated": "2018-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS43901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.